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[Meg Faure] You’ve made it to the third trimester.
Your bag’s not packed, the birth plan feels
overwhelming, and your toddler has no idea what’s coming.
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Today I’m joined by Dr. Nellie Balfour.
My name is Meg Faure, and in this episode
we’re tracking what’s happening as Nellie approaches birth.
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We’ve been following Nellie, who’s a paediatrician,
all the way through since the first trimester —
and now she’s almost there.
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In this episode, Nellie and I get into everything
you need to know about birth, and particularly
C-section births, because she’s having an elective C-section.
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We talk about baby sensory personalities —
whether you can actually tell what your baby’s
going to be like from their movements in utero.
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We also talk about the hospital bag,
what you actually need, what you can leave at home —
and those first moments straight after birth.
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What is an APGAR score? Why is cord clamping
timing important? And what is a paediatrician doing
in the room when your baby is born in a C-section?
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Welcome to Sense by Meg Faure, where we make
sense of the science and art of parenting.
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[Meg Faure] This is your space.
You’re not alone. You’re held.
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Right, Nellie, it’s so lovely to have you with us today.
How many weeks are you?
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[Dr. Nellie Balfour] Thanks, Meg. I love being back.
I am 35 weeks and three days.
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[Meg Faure] Oh my goodness, you are right
into that last stretch now. How are you feeling?
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[Dr. Nellie Balfour] I’m feeling good.
I’m feeling ready to meet this little guy.
I’m tired, but weirdly I have enough energy for all the nesting.
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[Meg Faure] So what would you say about this third trimester?
What are you focused on right now?
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[Dr. Nellie Balfour] I’m having an elective caesarean section.
My firstborn was also born by elective C-section.
I don’t think there’s much difference in outcome.
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There are studies about the microbiome
and vaginal delivery, but elective C-section
is safe and it’s the right choice for me.
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And I always say — it doesn’t matter how your
baby comes out, as long as you and your
baby are safe. You’re still a mum at the end of the day.
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[Meg Faure] Let’s talk a bit about his personality.
We already have a few indicators in utero.
How busy has he been compared to your firstborn?
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[Dr. Nellie Balfour] Very busy. My firstborn kicked often,
but this little guy is doing somersaults, tumbling around.
He’s a little acrobat. I think he’s going to be a firecracker.
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[Meg Faure] I love to think about sensory personalities —
how babies engage with their world through their senses.
You get your sensory seekers, the social butterflies.
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Those little ones are very social,
wired for interaction, and they love a lot of sensory input.
They can be quite exhausting babies and toddlers.
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When we understand our baby’s sensory personality,
it helps us with everything from weaning to
sleep in those early days.
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[Dr. Nellie Balfour] I love all your work on sensory personalities.
I watched your webinars with my first one when he was a newborn.
He’s always been slow to warm.
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[Meg Faure] Slow to warm is a very precious personality.
They observe the world before they throw themselves in.
Once they’re comfortable, they’re an utter delight.
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What does happen is that slow to warm little ones’
worlds get disrupted quite significantly
when anything new happens.
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The newness of a new baby — particularly if the baby’s
a busy social butterfly — is potentially going to
be disruptive for your firstborn.
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Talk through what’s coming, prepare the room,
show him the room, and talk about what’s going
to happen each day. Verbal preparation really helps.
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[Dr. Nellie Balfour] He is very observant and watches people
in his environment before he feels comfortable.
But once he does, his personality really comes out.
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I do have concerns about how he’s going to adjust
to his baby brother. I think his brother
might be a social butterfly.
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[Meg Faure] What makes things a lot easier
is when a parent has insight.
You can co-regulate for him.
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Recognise when he’s becoming overstimulated,
take him for a walk while you settle the baby,
and then turn your full attention back to him.
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[Dr. Nellie Balfour] My husband is arriving tomorrow.
He’ll be here for the birth and for a
significant amount of time afterwards.
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[Meg Faure] Let’s talk about the hospital bag.
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For mum: I’m a huge fan of the Carrywell range.
Linen savers for the hospital bed, maternity bras,
maternity pads, maternity underwear.
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People forget a phone charger. Always pack one.
Also a peri bottle — mainly for natural births
to clean and soothe the area after delivery.
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A breastfeeding pillow, slippers, flip flops for the shower,
and a front-button nightie — not pyjama pants,
especially for a C-section. The elastic irritates the scar.
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The buttons are for quick breastfeeding access.
Also a gown, a breast pump, and breast pads —
on day two or three, your milk comes through like a tap.
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I’m not bringing a speaker. I just slept.
When I was awake, I was with my baby.
The C-section itself is 20 to 30 minutes and then you’re back in your room.
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[Meg Faure] And for the baby bag?
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Unscented wet wipes. Cotton wool with surgical spirits
for the umbilical stump — clean with each nappy change
to help it heal and prevent infection.
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Outfits and beanies — babies lose a lot of heat
from their heads. Swaddles help baby feel
contained and comfortable, and they sleep longer.
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And a pacifier. Sometimes when baby can’t be soothed,
that sucking motion really helps them
calm down or drift off.
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[Meg Faure] With premature babies, we actually insist on dummies
because they need to develop their suck reflex
in order to breastfeed.
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The risk with dummies isn’t nipple confusion —
it’s whether a mum is skipping a feed.
Feed regularly, then use the dummy after the feed.
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[Dr. Nellie Balfour] One hundred per cent agree.
Also blankets, a gentle fragrance-free cleanser,
moisturiser, vests, and warm layers for a winter baby.
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[Meg Faure] There’s good research showing that not bathing
early is beneficial — it gives skin time to
absorb the vernix. So not before day three.
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[Dr. Nellie Balfour] That’s exactly what happens now
in private and public hospitals.
At 72 hours, baby gets the first bath.
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[Meg Faure] And speaking of evidence-based practice —
delayed cord clamping. Is that possible
with a C-section?
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[Dr. Nellie Balfour] Yes, we do it with elective C-sections,
and as far as possible with emergency C-sections too,
as long as baby is breathing.
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Delayed cord clamping means not clamping the cord
within 30 to 60 seconds of birth so that blood
can transfer from mum to baby.
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Benefits include lower risk of anaemia
and lower risk of jaundice.
If baby needs resuscitation, we clamp immediately.
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[Meg Faure] In terms of those first moments —
does baby go straight onto your chest
or to the paediatrician?
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[Dr. Nellie Balfour] It depends on the baby and what you request.
If mum requests skin-to-skin and baby is healthy
and pink, that’s completely fine.
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Then baby comes to the paediatrician for examination
and goes right back to mum. If baby needs resuscitation,
baby comes straight to us first.
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[Meg Faure] You as the paediatrician —
what are you looking for when baby is passed to you?
Talk us through it.
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[Dr. Nellie Balfour] We examine baby from head to toe.
We want baby to cry — it doesn’t have to be
a sustained cry, just a whimper, as long as baby is breathing.
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Crying tells us oxygen is going in and out.
The louder and longer the cry,
the more oxygen we know baby is taking in.
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We expect baby to be blue or purplish at first.
After about five to ten minutes, we want to see pink.
A lot of dads get a fright — but it’s completely normal.
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We look at activity — is baby flexed, limbs active?
We don’t want a floppy baby, we don’t want a quiet baby,
we don’t want prolonged blueness.
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Baby is shown to mum and dad briefly first,
then passed to us. We examine head to toe:
heart, lungs, abdomen, limbs, ten fingers, ten toes.
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Once we’re happy with everything,
baby goes right back to mum and dad.
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[Meg Faure] And do you rank the APGAR, or does the nurse?
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The APGAR is a score out of 10.
It covers appearance, breathing, activity,
colour, and heart rate.
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The score tells us whether we’re happy with how baby is doing,
or whether baby needs more attention —
extra oxygen, monitoring, or ICU care.
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[Meg Faure] It’s not “7 out of 10” — it’s 7 at one minute
and 10 at five minutes. A low first score isn’t alarming
if the five-minute score is high.
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[Dr. Nellie Balfour] Exactly. It’s the five-minute APGAR
that counts for more. Your one-minute can be 5,
your five-minute can be 8, and we’re happy.
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[Meg Faure] Thank you for joining me today.
I hope this conversation brought you a little more
clarity, calm, and confidence on your parenting journey.
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